Although I no longer have substantive contact with patients, I interpret the brief article in the August 2004 issue ("Microbes hitch a ride on physicians' neckties," page 18) to indicate that my profession-long (30+ years) routine of wearing bow ties has been beneficial to my health.
If clinicians switched to bow ties, not only would they deny opportunistic microbes a route to their skin and innards, but they would no longer have to worry about spilling food on the tie or dipping it into their soup, tomato sauce, and so on. Hostile patients would not have this ready item to grab in an attempt to get their doctor's attention or strangle them.
My observations in several teaching hospitals over the past decade or so strongly support the argument that radiology residents are not at all at risk. They wear long ties only to interviews and sometimes to funerals. They consider scrub tops to be sartorially "formal" and commonly just wear t-shirts or polo shirts.
Joseph M. Becker, M.D., M.S.
Temple University Hospital, Philadelphia
I chose to wear bow ties quite early in my medical life. When I was practicing general medicine during my residency/fellowship, several patients told me that I looked too young to be a real doctor!
The only day I wore a long tie was when my wife and I got married at her church, but I went back to the bow tie in the evening for the wedding party.
Two other advantages were not mentioned in the paper:
1. A silk bow tie is about half the price compared with a long tie.
2. I do not need to do the knot every day, and this is time-efficient.
A major "con" against the bow tie, in France at least, is that it represents a symbol of medical arrogance. I agree that most of our young residents look grungy and cannot be distinguished from the nonmedical personnel.
Robert Lavayssiere, M.D., Paris